P451 Specific Oral Manifestations in Patients with Crohn's Disease

Abstract

Abstract Background Extra-intestinal manifestations of Crohn's disease (CD), including arthropathic, mucocutaneous, ophthalmic and hepatobiliary disorders, have a prevalence ranging from 16.7% to 40%. Oral manifestations of CD are classified into specific manifestations directly related to intestinal inflammation and non-specific manifestations. The aim of this study was to determine the frequency and characteristics of specific oral manifestations in patients with CD. Methods We retrospectively evaluated 676 patients with CD who were followed up for at least 6 months between June 2013 and February 2023 at our tertiary care center. Specific oral lesions were clinically defined as cobblestoning, orofacial granulomatosis, lip/cheek swelling with fissuring, and pyostomatitis vegetans. Confirmation of specific lesions was made by experienced dentists for each case. Results Of the 676 CD patients (58.9% male, median age 38 years) followed for 6.83 years (IQR 3.45-11.76 years), 96 (14.2%) had oral lesions. Specific oral lesions were found in 8 patients (1.2%), while 88 (13.1%) had non-specific lesions. The specific lesions included cobblestoning (n=2), orofacial granulomatosis (n=3), glossitis with fissuring (n=2), and lip swelling with fissuring (n=2). Patients with specific lesions were predominantly male (75%) with a median age of 46.5 years (range 23-68 years). Disease location was ileal (25%), colonic (25%), and ileocolonic (50%), with perianal disease in 50%. Disease behavior was inflammatory in 7 and penetrating in 1 patient. Three patients were active smokers. Three patients had prior major abdominal surgery. Concurrent extraintestinal manifestations included peripheral arthritis/arthralgia (n=7), sacroiliitis (n=1), and uveitis (n=2). Immunomodulators were used in 7 patients and biologics in 5 patients. All specific lesions were associated with active disease (median CRP 35.5 mg/L, range 6-151 mg/L; median CDAI 313, range 227-480) and improved with immunomodulator or biologic therapy. Conclusion In this large cohort of CD patients, the frequency of specific oral manifestations was 1.2%. These lesions were associated with active disease and improved with immunosuppressive treatment, highlighting the need for close collaboration between gastroenterologists and dentists for early recognition and optimal management.